Stein Phyllis K, Le QuyChi, Domitrovich Peter P
Washington University School of Medicine, Heart Rate Variability Laboratory, St Louis, MO 63121, USA.
J Electrocardiol. 2008 Mar-Apr;41(2):110-5. doi: 10.1016/j.jelectrocard.2007.11.005.
Cardiac patients often have sinus arrhythmia of nonrespiratory origin (erratic sinus rhythm [ESR]). ESR was quantified using hourly Poincaré and power spectral heart rate variability plots from normal-to-normal interbeat intervals and hourly values of the short-term fractal scaling exponent and correlations of normal-to-normal intervals in n = 60 nonsurvivors and n = 66 randomly selected survivors in the Cardiac Arrhythmia Suppression Trial. Hours were coded (ABN) as normal (0), borderline (0.5), or ESR (1). t Tests compared ABN for n = 2413 paired hours at baseline and on therapy. ABN was higher in nonsurvivors (0.38 +/- 0.44 vs 0.28 +/- 0.40, baseline, and 0.51 +/- 0.45 vs 0.34 +/- 0.43, on therapy, P < .001). Increased ABN with treatment were greater in nonsurvivors. Normal hours at baseline (relative risk = 0.77; 095% confidence interval, 0.62-0.96, P = .018) and on treatment (relative risk = 0.47; 95% confidence interval, 0.39-0.58) were significantly associated with decreased mortality compared with ESR. Quantification of ESR may identify more vulnerable patients or help monitor the effects of pharmacologic treatment.
心脏病患者常出现非呼吸性窦性心律失常（不稳定窦性心律[ESR]）。在心律失常抑制试验中，对n = 60例非存活者和n = 66例随机选择的存活者，使用逐小时的庞加莱图和功率谱心率变异性图（基于正常心跳间期）以及逐小时的短期分形标度指数值和正常心跳间期的相关性来量化ESR。小时数被编码为（ABN）正常（0）、临界（0.5）或ESR（1）。t检验比较了基线和治疗时2413对配对小时数的ABN。非存活者的ABN更高（基线时为0.38±0.44对0.28±0.40，治疗时为0.51±0.45对0.34±0.43，P <.001）。治疗时ABN的增加在非存活者中更大。与ESR相比，基线时（相对风险 = 0.77；95%置信区间，0.62 - 0.96，P =.018）和治疗时（相对风险 = 0.47；95%置信区间，0.39 - 0.58）的正常小时数与死亡率降低显著相关。ESR的量化可能有助于识别更易患病的患者或监测药物治疗的效果。
